Provider Demographics
NPI:1003460783
Name:GARCIA, KATHERINE (PT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12684 MANOR WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3620
Mailing Address - Country:US
Mailing Address - Phone:530-885-7308
Mailing Address - Fax:
Practice Address - Street 1:102 CATHERINE LN STE A
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5701
Practice Address - Country:US
Practice Address - Phone:530-478-1933
Practice Address - Fax:530-478-1937
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251N0400X
CAPT208922251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology